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老年患者胰十二指肠切除术的结果与并发症:一项综述

Outcomes and Complications of Duodenopancreatectomy in Octogenarian Patients: a Review.

作者信息

Coco Danilo, Leanza Silvana, Viola Massimo Giuseppe

机构信息

Department of General Surgery, Giglio Hospital Foundation, Cefalu', Italy.

Head of Department of Oncology, Giglio Hospital Foundation, Cefalu', Italy.

出版信息

Maedica (Bucur). 2023 Dec;18(4):705-711. doi: 10.26574/maedica.2023.18.4.705.

Abstract

Duodenopancreatectomy is a surgical procedure that involves the removal of part of the pancreas, duodenum, and bile ducts. This procedure is commonly performed in patients with pancreatic cancer or other gastrointestinal disorders. However, the safety and efficacy of duodenopancreatectomy in older adults (octogenarians) remain unclear. The goal of this review is to assess the outcomes and complications of duodenopancreatectomy in octogenarian patients. A systematic search of relevant literature was conducted using PubMed, Embase and the Cochrane Library databases. Studies reporting the outcomes and complications of duodenopancreatectomy in octogenarian patients were included. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Egger's test was used to evaluate publication bias. A total of 14 studies were included in this review. The outcomes of duodenopancreatectomy in octogenarian patients were generally favorable, with a median 30-day mortality rate of 3.5% (range 0-16.7%). The most common complications were pancreatic fistula (12.2%), delayed gastric emptying (6.3%) and wound infection (5.5%). The overall long-term survival rate of octogenarian patients after duodenopancreatectomy was 21.2%. Duodenopancreatectomy can be safely performed in carefully selected octogenarian patients with good outcomes. However, this procedure is associated with a high risk of complications, particularly pancreatic fistula, in this age group.

摘要

十二指肠胰切除术是一种外科手术,包括切除部分胰腺、十二指肠和胆管。该手术常用于胰腺癌或其他胃肠道疾病患者。然而,十二指肠胰切除术在老年人(八十多岁的人)中的安全性和有效性仍不明确。本综述的目的是评估八十多岁患者接受十二指肠胰切除术的结果和并发症。使用PubMed、Embase和Cochrane图书馆数据库对相关文献进行了系统检索。纳入了报告八十多岁患者十二指肠胰切除术结果和并发症的研究。遵循了系统评价和Meta分析的首选报告项目(PRISMA)指南。使用Egger检验评估发表偏倚。本综述共纳入14项研究。八十多岁患者十二指肠胰切除术的结果总体良好,30天中位死亡率为3.5%(范围0-16.7%)。最常见的并发症是胰瘘(12.2%)、胃排空延迟(6.3%)和伤口感染(5.5%)。八十多岁患者十二指肠胰切除术后的总体长期生存率为21.2%。在精心挑选的八十多岁患者中,十二指肠胰切除术可以安全地进行,且效果良好。然而,在这个年龄组中,该手术与高并发症风险相关,尤其是胰瘘。

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